瘢痕子宫妊娠不同引产方法的结局分析  

Analysis of the results of induced labor with scarred uterus by different methods

作　　者：陈金红[1] 吴朝勇[1] 沈晓燕[1] 王军梅[2] 

机构地区：[1]浙江省绍兴市妇幼保健院妇产科,浙江绍兴312000 [2]浙江大学医学院附属妇产科医院超声科,浙江杭州310006

出　　处：《中国现代医生》2014年第15期31-34,37,共5页China Modern Doctor

基　　金：浙江省卫生厅医药卫生计划项目(2011KYA099)

摘　　要：目的探讨瘢痕子宫妊娠安全有效的引产方法。方法回顾性分析75例瘢痕子宫妊娠引产患者的临床资料,采用药物(n=22)、乳酸依沙丫啶羊膜腔注射(n=30)、水囊(n=23)引产,观察三组的宫缩发动时间、排胎时间、引产成功率、阴道出血量、胎盘胎膜残留率、引产并发症及用药不良反应。结果三组引产方法的引产成功率、阴道出血量、子宫破裂差异无统计学意义(P>0.05);乳酸依沙丫啶羊膜腔注射组宫缩发动时间、胎盘胎膜残留率、宫颈会阴裂伤与药物组、水囊组相比,差异有统计学意义(P<0.05);水囊组排胎时间与药物组、乳酸依沙丫啶羊膜腔注射组相比,差异有统计学意义(P<0.05);药物组不良反应与乳酸依沙丫啶羊膜腔注射组、水囊组差异有统计学意义(P<0.05)。结论瘢痕子宫妊娠采用以上引产方法均可行。Objective To evaluate a safe and effective the induced labor methods for women with pregnancy scarred uterus. Methods A retrospective study was performed in 75 cases of pregnant women with pregnancy scarred uterus, All of these patients were divided into three groups according to the treatments： 22 cases were given Misoprostol（group A）,30 cases were adopted the method of amniotic cavity injection of Ethacridine Lactate （group B）,and 23 cases were induced by homemade-water bag（group C）. We carried out retrospective analyses of the interval time from administra- tion to uterine contraction, the interval time from induction to delivery, the successful rate of induced labor, vaginal bleeding volume, placenta and fetus membranes retention ratio, complications and adverse reactions data from all cases. Results There was no significant difference among three groups about the successful rate of induced labor, postpartum bleeding volume and the rate of rupture of uterus （P 〉0.05 ）. There were significant differences between the group B and the A,C two groups about the interval time from administration to uterine contraction, placenta and fetus mem- branes retention ratio, cervical and perineal laceration （P 〈0.05 ）.There were significant differences between the group C and the A, B two groups about the interval time from induction to delivery （P 〈0.05）, There were significant differences between the group A and the B, C two groups about adverse reactions （P 〈0.05）. Conclusion It is appropriate to use Misoprostol, amniotic cavity injection of Ethacridine Lactate or homemade-water bag for induced labor of pregnancy scarred uterus.

关 键 词：瘢痕子宫 引产 米非司酮 米索前列醇 乳酸依沙吖啶 水囊 

分 类 号：R719[医药卫生—妇产科学]